THE SECRET LIFE OF A MED STUDENT:
LIFE AFTER DEATH
By Lauren Hill, Fourth Year LSU Medical Student
It’s almost midnight
on a Friday in the
trauma ICU. My
chief resident on call
and I are awake,
standing outside of
a room at the end
of the hall. Mr. C., a
pleasant elderly man who, just
the day before, smiled back at us
very thankfully for participating in
a surgery that saved his life, now
lies unresponsive on life support.
As a fourth year medical student, this certainly was not my first
encounter with death and dying. It enveloped me at this point. I
was surrounded by what some would call “bad outcomes.” The
unusual thing, however, about Mr. C, at least from my standpoint,
was the rapidity of his decline. I had watched patients decline over
lengths of time in the hospital before, those who would come in
sick and become sicker. You knew their prognosis was not good,
and in a sense, both you and they were aware of the course of their
health. But such was not the case with this man.
I had been in and out of his room several times with the entire
trauma team since he went into cardiac arrest and required
mechanical ventilation and other life saving measures. As I stood
in the background of serious decision-making, one thing was very
clear: Everyone involved was equally puzzled.
What could have gone wrong? What did we miss? There were
just no answers.
Doctors are often so full of answers and responses, quickened with
confidence from their many years of training. As a student, we
watch the exchange between doctor and patient regularly, hoping
to emulate this same assuredness in our decisions. So as students,
we don our short white coats and practice confident speech using
abbreviations, technical phrases and smiling back at patients while
secretly knowing we have no idea what we are saying. To the
outsider we are perplexing and educated. We are full of knowledge.
We cure or we have the tools to do so. But on this night, I watched
a man slowly succumb to our shortcomings.
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We don’t know everything and sometimes whether we treat it or
not, the person, our patient, dies.
I pulled a chair up outside of Mr. C.’s room that night and
watched him from outside the glass. My resident called it “my
vigil,” but I feel it is important for someone to witness both a
man’s life and his death. The ventilator provided his breath, the
medications assured his heart would beat and that his blood
pressure would be within a normal range. However, even with
the most aggressive of actions, he died Saturday morning at
approximately 1:30 a.m.
His body was covered with a clean white sheet. The ventilators,
crash carts, IV bags and poles were all removed. The floor was
swept, the air was cleansed, and another bed was moved into the
room. All traces of Mr. C. had disappeared within the hour. When
I returned to the unit the next day, a new patient occupied the
space. I didn’t stop to look but I hoped as I always do. I hoped
that our knowledge, education, confidence and persistence would
combine in a serendipitous effort to do for that person what could
not be done for Mr. C. I hoped to not only save the body, but to
save the life.
Clearly, such salvation is not always possible, but it certainly is
the mission. BRH&F